Brazilian doctors jeer Cuban medics

RURAL HEALTHCARE:President Rousseff has vowed to improve the care available in remote regions by hiring foreign doctors to work in the poorer areas

The Guardian, RIO DE JANEIRO

Brazilian President Dilma Rousseff has accused the nation’s doctors of “immense prejudice” toward their Cuban counterparts after the first medics to arrive from Havana were greeted with jeers.

The Cuban doctors have been invited to work in Brazil to support the fragile health system — one of the issues that prompted mass protests in June. Under the government’s “Mais Medicos” (More Doctors) program, 4,000 Cuban professionals will work in poor and remote areas of Brazil that are short of hospital staff.

After the first contingent of 400 arrived over the weekend they were booed by local doctors, who oppose what they describe as a stop-gap measure that fails to address the need for more investment in hospitals and better pay for doctors.

A video of the encounter in Ceara shows Brazilian doctors chanting “slave” at the Cubans. This appeared to be a reference to a payment system under which the Cuban government will receive more than a quarter of the doctors’ monthly salaries.

Government officials have depicted Brazilian doctors as a cosseted urban elite, reluctant to move away from high-paying private institutions in Rio de Janeiro, Sao Paulo and other big cities.

The president strongly defended the Cuban doctors in a radio interview on Wednesday in which she stressed that the newcomers would only work in the Amazon and in remote places where domestic doctors were unwilling to practice. According to the president, there are 700 municipalities in Brazil without a single doctor.

Rousseff said fewer than 2 percent of the doctors in Brazil were foreign, compared with rates of 25 percent in the US and 36 percent in Canada. The Mais Medicos initiative aims to address the shortage by recruiting health professionals from Portugal, Argentina and elsewhere, but Rousseff said that only the doctors from Havana had been criticized.

“We have seen instances of immense prejudice against the Cuban doctors,” she said. “I can assure you we will do all we can within the law to bring doctors to places where there are no doctors.”

Medical expertise is one of Cuba’s main exports and has been used to cement ties between Havana and political allies overseas.

There are Cuban doctors in more than a dozen nations, including Venezuela — where they were paid for in oil under former president Hugo Chavez — and Haiti, where they have been on the frontline of efforts to rein in its cholera epidemic.

Brazil’s healthcare system is challenged by inequality and vast distances. According to the World Bank, the country has 1.8 doctors for every 1,000 people — well below the 3.2 ratio in Argentina, and significantly below those of Mexico, the US and the UK.

In the first stage of “Mais Medicos” 1,589 doctors were recruited, a third of whom were from other nations, including Spain and Russia. However, the government has said that almost 10 times this number is needed to fill the gaps in rural areas, particularly in the poor north and northeast of the country.

The shortfall will largely be filled by qualified foreigners. The government is also investing in medical colleges and hopes to see a sharp increase in the number of graduates over the next eight years.

Juan Delgado, a Cuban doctor, told reporters for the newspaper Folha that it would take time for attitudes to change.